Maedica最新文献

Background: SARS-CoV-2 infection posed multiple challenges for breastfeeding women. We intended to examine the impact of maternal coronavirus disease (COVID-19) on breastfeeding experiences and continuation. The aim was to generate insights that could inform strategies to support mothers in managing stress during illness and to promote positive breastfeeding outcomes.

Methods: Our survey recruited 120 Romanian breastfeeding women who contracted SARS-CoV-2 infection using a 46-item questionnaire. It was disseminated through Facebook, Instagram, obstetrics-related online communities and medical networks. We included questions which addressed demographic characteristics, breastfeeding practices, SARS-CoV-2 infection during lactation, related concerns and perceptions of the pandemic and disease period. Study participants were split into groups based on their symptomatology - mild or moderate COVID-19.

Results: Women with moderate SARS-CoV-2 infection reported greater physical impairment and more negative emotional symptoms compared with those with mild disease. Despite these challenges, breastfeeding practices were largely preserved: most mothers continued to nurse their infants, many maintained exclusive breastfeeding for over one year and nearly all refrained from isolating from their children. The adoption of additional hygiene measures reflected maternal awareness of transmission risks and a desire to mitigate them while sustaining close contact. The lack of significant differences in breastfeeding experience between women with mild and moderate infection indicated that, within this group, disease severity exerted only a limited influence on maternal decisions regarding infant care.

Conclusion: Maternal SARS-CoV-2 infection did not substantially disrupt breastfeeding practices or the mother-infant relationship despite the challenges of the disease. These findings highlight the importance of providing adequate healthcare support to infected mothers, both to reduce stress associated with breastfeeding under restrictive conditions and to promote practices that safeguard maternal and infant health.

Background: Third molar impaction is a prevalent dental condition with varying clinical presentations across populations. This retrospective study evaluated radiographic predictors and treatment outcomes of third molar impactions among adults in Saudi Arabia.

Materials and methods: A total of 791 panoramic radiographs obtained from patients referred to the Oral and Maxillofacial Surgery units at Dammam Medical Complex and Riyadh Elm University Hospital between 2018 and 2022 were analyzed. The angulation and level of impaction were assessed using the Pell and Gregory classification system. Statistical analyses, including logistic regression and chi-square tests, were performed to identify significant predictors of extraction.

Results: The study cohort had a mean age of 35.3 ± 11.8 years, with females representing 53.1% of cases. Vertical impaction was the most common type (49.3%), followed by mesioangular (27.7%) and horizontal (14.8%). Tooth #48 (mandibular right third molar) was the most frequently extracted (43.7%), followed by tooth #18 (33.3%) and tooth #28 (31.6%). Logistic regression revealed that age 31-45 years, referral for extraction based on radiographic evaluation, impaction of tooth #48, Pell and Gregory Class II and Position B were significant predictors of extraction (p < 0.05).

Conclusion: Overall, 36.7% of cases required surgical extraction, whereas 63.3% were managed conservatively with periodic follow-up. These findings underscore the clinical value of early radiographic evaluation and individualized treatment planning to minimize complications associated with third molar impactions.

Background and objective: Evaluation of anatomical structures, such as the maxillary sinus septa, is critical for the success of sinus surgeries. This study compared the morphological patterns and locations of maxillary sinus septa in dentate and edentulous patients using cone-beam computed tomography (CBCT).

Methods: This retrospective descriptive-analytical study included 164 patients (327 maxillary sinuses) who were referred to a private radiology clinic in Ahvaz during 1399-1400. Cone-beam computed tomography images were obtained using a NewTom VGi unit and evaluated with NNT Viewer software. Data were analyzed using SPSS software version 26 and the chi-square test and analysis of variance.

Results: Of the 327 sinuses examined by us, 135 septa (41.2%) were identified. The prevalence of septa in the complete dentition (32.8%), complete edentulism (27.8%) and partial dentition (34.1%) groups did not differ significantly. Septa were most frequently located on the lateral wall (48.1%) and the distribution of septal location among the different groups was statistically significant (P = 0.042). The vertical morphological pattern was the most commonly found one (53.3%) and the molar region showed the highest frequency of septa (58.8%). The mean septal length was 8.23 mm.

Conclusion: The findings indicated that maxillary sinus septa are common structures, predominantly with a vertical pattern and located on the lateral wall and in the molar region.

Background: Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity often requiring surgical correction in progressive cases. While posterior spinal fusion (PSF) is the standard treatment, long-term outcomes beyond 10 years and the impact of Lenke classification and fusion length on patients' quality of life remain underexplored. This study aims to evaluate the 10-year postoperative outcomes of AIS patients treated with PSF, comparing results across different Lenke curve types and fusion lengths. Methods: This retrospective study with a minimum follow-up of 10 years analyzed a cohort of 98 AIS patients who underwent PSF. Those with neuromuscular, congenital, or syndromic scoliosis were excluded. Outcomes included radiographic parameters and patient-reported metrics: SRS-22, SF-36 and Oswestry disability index (ODI). Subgroup analyses were performed based on Lenke classification and number of vertebrae fused. Results: Patients showed excellent long-term outcomes, with a mean SRS-22 total score of 4.5, SF-36 physical and mental scores above population norms and a mean ODI of 5.6%, indicating minimal disability. Lenke 1 patients (single thoracic curves) had superior outcomes in pain, satisfaction and total SRS-22 scores compared to those with more complex curves. Shorter fusions (≤nine levels) were associated with better function, self-image and lower disability, without compromising satisfaction or pain relief. Conclusion: Posterior spinal fusion in AIS yields durable improvements in function, pain and quality of life after 10 years. Shorter fusion constructs and simpler curve patterns are linked to slightly better outcomes, supporting selective fusion strategies when appropriate. These findings underscore the value of individualized surgical planning based on curve characteristics and motion preservation, while integrating modern technologies and AI models to further improve inter-reliability, decision making and patients' quality of life.

Background: Proton pump inhibitors (PPIs) are widely used for acid-related disorders. Recent evidence suggests potential associations between long-term PPI use and pancreatic dysfunction, though findings remain inconsistent. This study aimed to evaluate pancreatic function in patients on long-term PPI therapy.

Methods: A cross-sectional study was conducted in a tertiary care hospital from March 2023 to June 2024. Ninety-seven adults aged 18-65 years who were using PPIs (≥three doses/week for ≥eight weeks) were recruited from outpatient services. Patients with diabetes or those on medications affecting glucose metabolism were excluded. Blood samples were analyzed for C-peptide, amylase, glycated hemoglobin (HbA1c) and random blood sugar (RBS). C-peptide levels were categorized as normal (≤4.20 ng/mL) or abnormal (>4.20 ng/mL). Other biochemical parameters were also similarly classified using standard laboratory cut-offs. Prevalence of dysfunction was expressed as percentages. Associations between C-peptide levels and age, sex, amylase, HbA1c, RBS, PPI type and duration were assessed using odds ratios and Chi-square/Fisher's exact tests.

Results: Participants had a mean age of 51.2 years and 62.9% of them were females. The most common PPI was pantoprazole (76.3%). Abnormal C-peptide levels were observed in 10.3% of participants. Raised HbA1c levels were noted in 48.5% of subjects. There were no significant associations with pancreatic function and age, sex, type and duration of PPI treatment.

Conclusion: No definitive association between chronic PPI usage and pancreatic dysfunction could be established. A possible association may be suspected due to the high prevalence of raised HbA1c levels in long-term PPI users. Further studies are required to elaborate on these findings.

Objectives: To present recent advances in forensic sciences with omics sciences and new biomarkers for postmortem interval (PMI) estimation.

Materials and methods: We conducted a narrative review screening PubMed and Scopus databases in the last 10 years (2015-2025) with the following keywords in the title and abstract: "postmortem interval" OR "post-mortem interval" AND "proteomics" OR "proteomic" OR "metabolomics" OR "metabolomic" OR "transcriptomic" OR transcriptomics" OR microRNA" OR "microRNAs" OR "lipidomic".

Results: Conventional methods of postmortem interval estimation are presented. Some of the most important studies and molecular techniques in genomics, transcriptomics, proteomics, metabolomics, lipidomics, old and new biomarkers for postmortem interval estimation are summarized. Single-omics or multi-omics, critical issues like data reproducibility and interpretation, judicial validity according to Daubert standard and ethical issues of PMI research are discussed.

Conclusions: Postmortem interval estimation continues to be one of the most disputed issues of forensic medicine. Conventional methods for PMI estimation still offer a solid bench for practical means. As single-omics and multi-omics research continues to progress, we will likely discover new biomarkers and innovative techniques. Efforts will focus on identifying biomarkers that can deliver reliable and predictable outcomes, thereby facilitating their general acceptance and admissibility in legal proceedings.

Objectives: Among the molecules that are implicated in the regulation of apoptosis (programmed cell death), caspases are most significant acting as strong enhancers. The aim of the current study was to co-analyze the caspases 3, 8 and 9 at their protein expression level in a series of laryngeal squamous cell carcinomas (LSCCs).

Materials and methods: Tissue specimens derived from 50 LSCC cases were selected and co-analyzed for determining the caspase 3/8/9 expression. A combination of immunohistochemistry and digital image analysis assays was implemented.

Results: According to the analysis of the immunostained slides, females showed higher median expression levels of caspase 3/9 and lower caspase 8 compared to males. However, none of these differences reached statistical significance. Furthermore, median caspase 3 expression levels decreased from Grade 1 to Grade 3, and similar gradual changes were noted for other markers. However, none of these differences reached statistical significance, indicating that the distributions of the biomarkers did not differ significantly by grade. Interestingly, the median caspase 3 levels strongly decreased with stage and this difference was significant (p = 0.033). No significant differences were found across stages for caspase 8/9 and also regarding the anatomical region of the examined tumors.

Conclusion: Deregulation of caspase 3/8/9 molecules that regulate a crucial cataract of reactions in the apoptotic pathway is a relatively frequent event in LSCCs. Progressive loss of their expression is correlated with an aggressive phenotype in the corresponding malignancies, especially referring to caspase 3. Enhancing caspase 3/8/9 expression - that induces apoptotic rates in malignant tumors including LSCC - is a significant goal and challenge for developing novel targeted therapeutic strategies.

Background: Polycystic ovary syndrome (PCOS) has various causes that are largely unknown. The present study was aimed to evaluate metabolic and biochemical markers as well as body mass index (BMI) related to PCOS among two groups including patients and healthy controls.

Methods: A case-control study included women younger than 45 years who did not suffer from obesity. Women with male-factor infertility served as the control group, while patients detected with PCOS via the Rotterdam criteria made up the case group. There were 86 randomly selected participants in each group. Fasting blood sugar (FBS), lipid profiles, alanine aminotransferase (ALT) and other biochemical tests were gathered with demographic data, medical records, physical exams and anthropometric measurements. Ultrasound, liver enzyme levels and medical history were utilized to diagnose non-alcoholic fatty liver disease (NAFLD).

Results: About 172 women were selected for the research; 86 had PCOS, while the remaining 86 were healthy controls. A younger mean age and a higher BMI were found in women with PCOS. The findings showed that mild to moderate fatty liver was more prevalent in the PCOS group than the control one (P = 0.04). Although metabolic indices, liver enzymes, hematologic parameters and hormone levels did not alter significantly, the PCOS group had lower fasting blood sugar levels (P = 0.029). The correlation between total cholesterol and PCOS was still poor after adjusting for age in logistic regression analysis. Still, it became statistically insignificant after adjusting for BMI index.

Conclusion: Non-obese women with PCOS had a higher prevalence of fatty liver, with minor differences in metabolic parameters, and BMI partly mediated these associations.

Age-related hearing loss (ARHL), also known as presbycusis, is one of the most prevalent long-term sensory difficulties in older people. It affects more than two-thirds of people over 70. In addition to communication challenges, ARHL has recently been revealed as a possible modifiable risk factor for cognitive decline and dementia. Comprehending this link is crucial for creating preventative interventions and maintaining healthy cognitive aging. This narrative review intended to analyze the evidence comprehensively relating age-related hearing loss (ARHL) with cognitive decline, define the possible pathophysiological mechanisms that may explain this association and assess the plausibility of hearing rehabilitation as a preventative therapy. A full literature search was done in PubMed, MEDLINE, Google Scholar and Frontiers databases employing the phrases "hearing loss" AND ("cognitive decline" OR "aging"). We only looked at articles that were published in English between 2014 and 2024 and were either systematic reviews, meta-analyses, or original research. We did not include any papers that were not peer-reviewed, not about people or not written in English. A total of 37 publications satisfied the inclusion criteria and underwent extensive review. There is strong evidence that ARHL is associated with rapid cognitive decline and an increased risk of dementia. Epidemiological studies suggest that hearing loss contributes to roughly 8-9% of worldwide dementia cases, which represents one of the primary modifiable risk factors. Some of the suggested ways that ARHL and cognitive decline are connected include through increased cognitive load, neuroplastic rearrangement, vascular dysfunction, oxidative stress and social isolation. Neuroimaging studies have revealed a reduction in gray matter and cortical atrophy in the auditory and associative areas of the brain in individuals with hearing loss. Hearing rehabilitation with hearing aids and cochlear implants has been connected to increased communication, higher social engagement and decreased cognitive decline; nevertheless, findings are rather inconsistent due to methodological errors and limited follow-up periods. Age-related hearing loss is a moderately widespread risk factor for cognitive decline and dementia that can be reduced. Early examination and effective auditory therapy can slow down cognitive decline and make life better for older people. Future longitudinal, multicenter and interventional studies are important to explain causal pathways, enhance intervention timing and assess cost-effective public health techniques for sustaining cognitive health in aging populations.

Background: Müllerian duct anomalies (MDAs) comprise a heterogeneous group of congenital malformations of the uterus, cervix and vagina that can impair menstruation, sexual function and fertility. Over the past three decades, minimally invasive techniques have largely replaced laparotomy for their surgical management; yet, data remain fragmented across small series and diverse anomaly types.

Objective: To synthesize contemporary evidence on laparoscopic and robotic management of MDAs, highlighting indications, key surgical techniques and reproductive and functional outcomes, while addressing psychosocial and ethical considerations.

Methods: A comprehensive narrative review was conducted in PubMed, Scopus and Google Scholar (January 1995-June 2024) using predefined Boolean combinations for specific anomalies and minimally invasive procedures. We included English-language, peer-reviewed clinical studies and sizable case series (n ≥ 3) reporting laparoscopic, laparoscopic-assisted, or robotic management of congenital uterine, cervical, or vaginal anomalies. The review was designed and reported in accordance with SANRA guidelines for narrative reviews.

Results: Laparoscopy has become central to the management of fusion and obstructive anomalies. Laparoscopic Strassman metroplasty in selected bicornuate uteri and laparoscopic excision of rudimentary horns in unicornuate uteri achieve high rates of symptom relief, reduction in miscarriage risk, and subsequent term pregnancies, with fewer adhesions than open surgery. In uterus didelphys and obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), combined vaginal and laparoscopic approaches effectively relieve obstruction while preserving the functional uterus. For vaginal agenesis in Mayer-Rokitansky-Küster-Hauser syndrome, laparoscopic Vecchietti, Davydov and sigmoid vaginoplasties consistently provide anatomically adequate neovaginas and satisfactory sexual function. Robotic assistance facilitates complex suturing in selected reconstructions, but clear superiority over conventional laparoscopy has not been demonstrated.

Conclusions: Minimally invasive surgery has transformed the management of MDAs by enabling effective correction of complex malformations with reduced morbidity and favorable reproductive and functional outcomes in appropriately selected patients. However, the evidence base is dominated by observational studies from specialized centers, with limited standardized reporting of fertility and psychosexual endpoints. Future multicenter, prospective research integrating uniform classification, core outcome sets and long-term psychosocial follow-up is needed to refine patient selection and optimize care pathways.